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Evidence review

Exit through the App Store?

A rapid evidence review of the technical considerations and societal implications of using technology to transition from the first COVID-19 lockdown

19 April 2020

Exit through the App Store? A rapid evidence review of the technical considerations and societal implications of using technology to transition from the COVID-19 crisis was undertaken with a view to supporting the Government and the NHS as it adopts technical solutions to aid in the transition from the COVID-19 crisis.

The review focuses on three technologies in particular: digital contact tracing, symptom tracking apps and immunity certification. It makes pragmatic recommendations to support well-informed policymaking in response to the crisis. It is informed by the input of more than twenty experts drawn from across a wide range of domains, including technology, policy, human rights and data protection, public health and clinical medicine, behavioural science and information systems, philosophy, sociology and anthropology.

The purpose of this review is to open up, rather than close down, an informed and public dialogue on the technical considerations and societal implications of the use of technology to transition from the crisis.

Key findings

There is an absence of evidence to support the immediate national deployment of symptom tracking applications, digital contact tracing applications and digital immunity certificates. While the Government is right to explore non-clinical measures for transition, for national policy to rely on these apps, they would need to be able to:

  1. Represent accurate information about infection or immunity
  2. Demonstrate technical capabilities to support required functions
  3. Address various practical issues for use, including meeting legal tests
  4. Mitigate social risks and protect against exacerbating inequalities and vulnerabilities

At present, the evidence does not demonstrate that tools are able to address these four components adequately. We offer detailed evidence and recommendations for each application in the report summary.

In particular, we recommend that:

  • Effective deployment of technology to support the transition from the crisis will be contingent on public trust and confidence, which can be strengthened through the establishment of two accountability mechanisms:
    • the Group of Advisors on Technology in Emergencies (GATE) to review evidence, advise on design and oversee implementation, similar to the expert group recently established by Canada’s Chief Science Adviser;
    • and an independent oversight mechanism to conduct real-time scrutiny of policy formulation.
  • Clear and comprehensive primary legislation should be advanced to regulate data processing in symptom tracking and digital contact tracing applications. Legislation should impose strict purpose, access and time limitations.

Until a robust and credible means of immunity testing is developed, focus should be on developing a comprehensive strategy around immunity that considers the deep societal implications of any immunity certification regime, rather than on developing digital immunity certificates. Full and robust Parliamentary scrutiny and legislation will be crucial for any future regime of immunity testing and certification.

Technical design choices should factor in privacy-by-design and accessibility features and should be buttressed by non-technical measures to account for digital exclusion.

We recognise that technology and data may be critical to enabling the UK to transition from the crisis, and acknowledge that lifting lockdown measures and getting people back to work has not only economic drivers, but social and public health drivers. But the rapid review finds that premature deployment of ineffective apps could undermine public trust and confidence in the long-term, hampering the widespread uptake of tracking technologies which may be critical to their eventual success.

This rapid evidence review is the beginning of our work to ensure new technologies that emerge to reduce the impact of the COVID-19 global pandemic work for people and society. We welcome approaches for further conversations and would be pleased to brief you or your colleagues on our findings, or consider your suggestions as to how to take this work further.

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